Life is… Surreal
I haven’t been able to write for the last few days because my wife and I have been out of town, vacationing with some of our dearest friends. But we’re back now, and I’m ready to start writing once again.
It’s been a surreal time, these last three and a half days. We’ve been so busy celebrating life and friendship and just being thrilled about getting away that I haven’t had time to think too much about all that other stuff: cancer; chemotherapy; medical decisions; insurance; the road ahead; and, yes, dying. Oh, those thoughts would creep in every now and then, when there were distinct reminders, but I had long stretches when I was able to completely forget the reality of the way things are.
So today I’m thankful for what we have just received. And to be completely honest, I’m not quite ready to let it go.
Christmas Thoughts
Here’s a question I get fairly often: Does it make you sad when a holiday (like Christmas) is over, because it might be your last?The answer is yes, it’s inevitable for the holidays to take on a bittersweet edge. I can’t help but think back upon all the great Christmases I’ve had. I remember how my sisters and I would stay up all night waiting for Santa to come. I remember getting presents like a new bicycle and a racecar track. I remember driving in the early morning to Tahlequah, where my extended family gathered to open presents. I remember trying to pick out the right gift for my wife. And I remember the days, not-so-long-ago, when my kids were little, how they’d walk into the living room with wonder in their eyes as they saw the stockings and presents waiting.
I love Christmas, so it hurts, terribly, to think this could be it.
But we cannot dwell on such things. For when we do, we trade away the potential for joy. The sadness is always there, waiting to sweep me away if I would allow it. Today it is Christmas. Tomorrow it will be something else.
Yes, trying times bring about inevitable moments of sadness. So when they do, we should take a little time to let that grief out in some positive way. And then we must put it away and move on.
As I’ve told my friends and family, now’s not the time for being sad. That time may be coming, but today isn’t it. Today, I’m alive and getting the wonderful gift of spending an entire day with my family.
Who knows what will happen down the road?
Can We Talk?
I received a letter today, December 23, 2008 (Christmas Eve Eve), that started me thinking. The letter was from a person I’ve only met a few times, so I don’t know her that well. But I do know that she’s kind and that she took the time to write me a very nice letter. I’m sure we could be friends, if given the opportunity.
Anyway, the letter was about this “Life is Real” series, how she’d been reading it almost daily. Despite the subject matter, the letter writer found the stories to be positive, and she thanked me for reminding her to live each day of her life. As a result of our efforts, she let me know that she was making a donation to cancer research in my name.
Letters like that can give you two or three days of renewed energy. Somehow, the series had impacted her, made a difference in her life.
But at the same time, my potential friend admitted that some of her colleagues found the series to be too sad. Try as they might, they simply couldn’t bear to read it.
I have to admit this bothered me a bit. Why? Because it’s so dad-gum true! No matter how hard I try, I simply can’t escape the underlying sadness of what we’re doing here. No matter what particular spin I put on it, the truth is we are writing about extremely painful things. A wife will probably lose her husband. Two kids are likely to lose their father. A mother and father are facing the loss of their son.
On the other hand, I’m not a sad, “oh woe is me” type of person. Oh, I have my quirks, but overall I’m fairly positive. Plus, as the old Disney song says, I love to laugh. A lot. I find humor in almost everything, even this.
But it’s a challenge, a true writer’s dilemma, to find the right balance between staying positive and telling it like it is. If I focus only on the good stuff or joke around too much, I may sound flippant or insensitive. People may think I’m in denial, or, worse, I may place the most important element of this story, honesty, in jeopardy. But if I’m too sad, well, who needs that? People are messed up enough without me helping them along.
Death is surely a taboo subject in America. Some people are fairly open about it, but a great many would rather talk about practically anything else. (Shoot, I can name dozens of people who refuse to read a sad book or watch a film that doesn’t have a happy ending.)
But by committing to this series, the Oklahoman is putting that issue up for debate. “Can we talk about death?” they’re asking. And if not, why? Is it better to live with our heads in the sand or should we think about such things from time to time?
Can we handle the truth?
I’m reminded of a great conversation between Professor Hilbert and Harold Crick, that would-be tragic hero in the film Stranger Than Fiction. Harold tells the Professor that “I can’t die right now. It’s just really bad timing.” And Professor Hilbert responds with this observation: “No one wants to die Harold, but unfortunately we do. Harold, listen to me. Harold, you will die, some day, some time. Heart failure at the bank. Choke on a mint. Some long, drawn-out disease you contracted on vacation. You will die. You will absolutely die. Even if you avoid this death, another will find you… I’m sorry, but it’s the nature of all tragedies, Harold. The hero dies, but the story lives on forever.”
For what it’s worth, regardless of whether I’m living out a tragedy or a romantic comedy here, I’m doing my best to make the story as poetic and meaningful as the one written for Harold Crick, a story that is positive and funny and, yes, at times rather sad. The story may not live on forever, but perhaps, just perhaps, it will spark some debate and make a difference for some of those who give it a chance.
Taking the Shuttle
A few years ago, I was in Houston for one of my regularly scheduled health checks at M.D. Anderson Cancer Center. It was time to see, once again, whether or not cancer was going to make another attempt on my life.
I was traveling by shuttle from Houston Hobby airport, a twenty-minute drive that costs twenty bucks, and I was not alone. There was one other passenger that day, a guy who was a decade or so younger than me, perhaps thirty.
When you grab one of those airport shuttles, you never know who’s going to be joining you. There may be one other person; there may be five. Plus, you don’t know what their stories are. Different shuffles take different routes and make different stops, but as a general rule when you’re heading toward Houston’s medical district, most of the people on board have at least some connection to illness. Not necessarily cancer, mind you, but if they’re heading toward the medical district from the airport, you can pretty much bet that either they or someone in their family is seriously ill.
Because of this serious illness connection, these airport shuttles can also be awkward. When you get on board, you may or may not feel like talking that day. You may be too antsy about upcoming appointments. You may have had a bad morning. You may be feeling blue or existential. That breakfast sandwich you ate at the airport may not be sitting quite right.
Or you may want to engage somebody that day, asking appropriately probing questions to your shuttle neighbor while making sure you aren’t forcing someone to talk who’d really rather not. For you don’t want to be that person who’s talking too much, filling up every stretch of silence with nervous chatter or meaningless observations.
On this particular spring day, I was feeling upbeat. Although I’d been through a lot, cancer-wise, things seemed to be going my way of late. And so, as I looked at the guy sitting beside me, I thought, well, I guess I could be friendly and chat a bit.
“So, where you heading?” I asked.
“M.D. Anderson,” he said, in an amiable way.
“Oh really? Me too,” I confided.
“Appointment time?” he asked.
“Yep. Time for check-ups,” I said. “How ‘bout you?”
“Yeah, something like that…”
I could have ended it there. I mean we had exchanged pleasantries. We had revealed a bit of meaningful information. We were brothers, in a way, joined by that most unpleasant bond, cancer.
But I decided to probe a bit further.
“So, what’re you in for?” I asked.
“Uh, lung cancer.”
Ouch, I thought. I don’t know everything about cancer, but I did know that lung cancer was one of the biggies. That is, one of the deadliest kinds around, if not the deadliest.
“And you?” he asked.
I told him about the cancer that had been recurring in my arm. And then we’d come to another logical stopping point. But I plodded on.
“So, what’s the prognosis?” I asked, somewhat boldly.
“Three months.”
“What?” I replied, believing I’d misheard him.
“Three months.”
“Three months? Are you kidding?” I responded. “You look fine. I mean, I can’t even tell there’s anything wrong!”
“Yeah. I get that a lot. But they just found it too late. So now I’m looking into experimental stuff…”
Now, several years later, that conversation haunts me. My brief friend, I must assume, has been dead for some time, and it’s as if I’ve somehow stepped into his place. I am now that (fairly) young person who doesn’t look like he’s about to die, at least for now. I’m the one who surprises people when they hear of my condition. I’m the one who leaves people questioning whether any of the dire news could possibly be true. I am the guy with lung (and liver) cancer who’s embarking on an experimental adventure.
I’m not exactly sure why I wanted to tell you this story. But to be completely honest, I find something poignant and ironic in it. Something about meeting people, talking to them, listening, and saying goodbye. Something about appearances and expectations. Something about life and death, the way things are, the rotating Ferris wheel we step on and ride for as long as we can until it’s time to step off.
And I find truth in the loneliness involved, some young kid, nameless, riding to a medical appointment during the last ninety days of his life. Such is the nature of cancer. No matter how many friends you have, and I have many, at times you’re on that shuttle, riding somewhere unknown, all alone.
Therapy
I have this poem called “Two Guys in Therapy” that was published in Oklahoma Today magazine last summer, in the issue focusing on barbeque. The running joke, or observation, in that poem is that guys are pretty clueless when it comes to depression and therapy. Rather than going to see a professional (therapist, psychologist, psychiatrist, priest, pastor, or shaman), guys tend to go to their favorite barbeque joint and pig-out.
While I like to poke fun at guys, cause we deserve it, you’ve gotta be careful when it comes to issues like depression, counseling sessions, medication, and what not. (Look at what happened to Tom Cruise.) It’s a serious topic, one that each person will probably have to muddle through at some point in his or her life, so long as they live in a country where such options are somewhat affordable.
As for me, I’ve seen my share of therapists, some helpful, some not so much. As a general rule, I think therapy can be wonderful and is, at times, critical. And the same is true for medication. Although it’s arguably true that America is a bit overmedicated, there are conditions and circumstances for which prescribed medicine is truly a lifesaver.
Due to my crappy health, people tend to assume that I’m in some sort of intense ongoing psychotherapy and that I’m popping pills like a guy eating popcorn at a movie.
However, truth is I’ve developed my own mental health wellness plan. It began long ago with a lot of reading, writing, and visits to a variety of professionals in the field, from psychiatrists to church counselors. But it has adapted over time. It is deeper now, more thought out and helpful.
Reading and writing are essential to the plan. Writing, and poetry in particular, is one of my primary methods of flushing the psychological and emotional toxins that build up inside me. Now I understand that many people don’t have creative outlets for the stress and grief they’re experiencing. Few of us are writers and a heck of a lot fewer than that are poets.
But anyone can read, and everyone should be doing it on a regular basis. In addition to books covering a specific topic I may be interested in (like mental health), I tend to choose books about “real stuff,” which means nonfiction, honest poetry, and time-tested classics. Plus, my wife LeAnn reads a lot of books about other cultures, so I get to select from her highest recommendations.
Beyond reading, I do a heck of a lot of one-on-one talking with friends, the true counselors of my life. Each of these friends serves a different function, and together they have helped me make it through this physically and emotionally taxing journey. I’d like to mention some of them here, because they deserve it.
I meet regularly for breakfast with my friends Don Hull and Molly Griffis. Don is older than me, a college professor, writer, cancer survivor, and former minister. With approximately seventy years under his belt, he has much to say about marriage, parenting, work, and spiritual matters. But he’s also very practical. He calls every week, no matter what. He drove me back and forth from physical therapy, and he has rescued me at chemo more than once. From time to time, he swings by work to take me to lunch or by the house with a coconut creme pie, my favorite. And he’s also cleared my yard of leaves several times, knowing that one-armed guys like me are not good with rakes.
I meet with Molly a couple of times a month. She is my advisor on the business of writing. As a former publisher and well-known author of children’s books, Molly tells me who I should call or connect with. Due to my difficulties stuffing envelopes, she mails out books for me whenever someone orders them through my website. That’s a huge help. She lost her husband to cancer last year, so we traveled that journey together. I’m sure she’s adapting to living alone after fifty years (or so) of marriage, so I think our friendship is as helpful to her as it is to me.
I meet with other friends for lunch on a regular or semi-regular basis. I’ve been meeting with Patti Parrish since we worked together at a law firm in the early nineties. Patti is now a District Court judge, and we’re often joined by others who worked with us (Martha Marshall, Travis Pickens, or Lisa Davis). Patti and I are brother and sister in pain. Mine has to do with cancer and the loss of my sister Karyn in a car accident. Among other things, Patti lost her husband in a freakish train accident, her sister to cancer, and her adopted daughter April was murdered by her husband. And together we shared the painful loss of our dear friend and coworker Doyle Bunch, who drowned in a tragic scuba diving accident. Patti and I have a commonality that is unusual in this area.
I meet at least once a month with my good friend Charlotte Lankard. Charlotte is a counselor at Integris Hospital, and she writes a column for the Oklahoman. She is one of the kindest people I know, and she was the driving force behind this “Life is Real” series. Charlotte lost her husband to cancer some years ago, so she identifies with my circumstance personally. She also lost her adopted son quite recently. She’s been through other pain too, physical and relational. So we share a lot in common. As a counselor, she asks me the questions no one else asks, or even thinks of, and she serves a therapist role in my life too that is an extension of our friendship.
Nathan Brown is my poetry buddy and my creative collaborator. We meet for lunch at the Red Cup when we can, and we do a lot of poetry readings and like events together. He gets a gig and invites me to join him, and vice versa. We share a writing madness that is difficult to explain, but it’s good to know there are other crazies out there too. He tries to be the friend who helps me forget about my health and future, however briefly.
LeAnn and I have a whole host of friends we meet with regularly for dinner or a night on the town. Don and Shellie Greiner were our college buddies, and we’ve remained close over the years. We’ve gone on vacation together, attended the theater with them on many occasions, and get together as often as possible for dinner. Don and I also do lunch here and there. They are some of the best people we know, and they’ve been there for us in more ways than they would ever let me relate in writing.
We also get together with Jack and Katie Kain quite often. Jack shares my addiction to the weather (but he’s a professional), and Katie shares my addiction (as well as LeAnn’s) for reading. Jack is philosophical, which I love, and he joins me for coffee whenever we remember to set a date. We talk about some tough things, and it hurts when I share something that brings him pain. But that’s life I guess, and he is wise about life.
We also meet for dinner with friends like Alan and Kerri Tiedeman, Kevin and Kristy Bloss, William and Ginger Murray, Pam and Dwight Normile. These are lifelong friends that have been meeting with us for years. We can get together with them and relax, able to be ourselves no matter what that may mean on the day in question.
At work, I’ve shared my ongoing journey with a host of friends, Lendell Blosser, Lou Kohlman, Allan Smith, Patty Grotta, Melanie Stucky, Linda McGuire, Arlene Johnson, students like Ashley and Linsey, and members of my staff. The whole place has been there for me, donating sick leave, giving my family presents we don’t deserve, praying.
I get together with other friends on more of a random basis, for an occasional meal, to watch a movie, to watch a game, or perhaps sample a tasty beverage. Dwight and Alan, mentioned above. David Payne, Jim Bishop, Mike Bumgarner, Andy Horton, Brooks Hull, Trent Bell, Scott Petty, Tom Hemry. And with many others, especially dear friends who are far away, I do my best to maintain a meaningful email relationship. They send cheerful notes, encouraging me to keep up the good fight.
The point is this: my wife and I have a tremendous circle of friends. We are truly blessed. Without them, I would be much worse off than I am–indeed I’d hate to think where I’d be. I often see folks at cancer centers that have no one at all. So I am lucky, and proud, to have such dear friends. They are therapeutic to me, having become an important part of my ongoing wellness plan.
Elf Awareness
In the weeks before Thanksgiving, my family was in a collective funk, with news of my health getting generally more grim, a lot of tough decisions to make, and the normal craziness that comes with the last two months of the year.
One night, tired, possibly depressed, we gathered for family night, which for us usually means movies and takeout Chinese food or pizza. We began discussing what movie to watch–what do you choose when you’ve just learned about your probable demise–and we all agreed that we needed some sort of pick-me-up. No tearful drama or intense action/adventure film. No nail biting suspense or disgusting horror film. No, we needed a comedy.
“How about Elf?” I asked.
It wasn’t even officially the “holidays,” but everyone agreed that Elf was the perfect choice. I mean, the film is chalk-full of laughs and great one liners. Plus, here’s a guy (Buddy, played by Will Ferrell) who’s eternally joyful and optimistic. That wouldn’t hurt. Besides, we owned our own DVD copy, so we could pop it in at a moment’s notice.
Fifteen minutes later the movie was going, and our mood was improving with each passing scene. Laughter, they say, is the best medicine.
Elf is an underrated film. Some think of it as another silly Will Ferrell comedy, like Anchorman or Taladega Nights. But it’s much more than that. It’s also part drama, part romantic comedy, part fish-out-of-water story, part coming of age tale.
Plus, it’s good and so darn quotable. I often find myself borrowing exclamatory words and phrases from the film, like ginormous, that’s shocking, son of a nutcracker, very sucky, and cotton-headed ninny muggins (an Elf synonym for total idiot). If LeAnn and I are overdue for date night or it’s dinner time and we haven’t bought groceries, I might ask, “Do you want to go eat food?”
Longer phrases are a bit harder to work in to conversation. But if I’ve been eating too many holiday treats of late, I might say I’ve been ”trying to stick to the four main food groups: candy; candy canes; candy corns; and syrup.” Or, if someone comments about our holiday decorations, a Christmas poem I’ve written, or a card or present we’ve sent, I’m apt to say that it’s “nice to meet another human who shares my affinity for elf culture.”
Other lines from the film come in handy during parenting. If the kids are fighting, I might remind them that ”there’s room for everyone on the nice list.” If one of them has decided to forego showering for a couple of days, I can say “you smell like beef and cheese” without being too mean. Since teenagers aren’t known for being overly touchy-feely with parents, I can get much further if I accompany my attempts with some Elf logic like ”I forgot to give you a hug” or “tickle fight!” And if one of them appears to be stretching the truth, I can give them a deeply concerned look and say, “You sit on a throne of lies.”
Other lines from Elf are useful for everyday life when you need to recalibrate a lousy attitude. What better stay positive reminder is there than to begin each day with a “smiling’s my favorite” attitude? And when things are going wrong at the end of the year, you can pick yourself and those around you up with this thought: “The best way to spread Christmas cheer is singing loud for all to hear!”
The bottom line’s this. Elf is a feel-good film that’s useful during feel-bad times. I want to stop being so tired, grumpy, and cynical. I want to be the kind of guy who believes when I see a store advertising the ”world’s best” cup of coffee. Like Buddy, I want to respond by stepping into the store and saying, ”You did it! Congratulations! Good job everybody!”
It’s All in the Timing
A friend asked about my attitude toward God. Was I angry? Did I sense God’s presence in my current situation? Did I even believe anymore?”It’s difficult,” I admitted. “Frustrating. Perplexing even. Most of the time I just feel tired.”
My friend was quiet.
“I pray, you know, but all I ever seem to get is silence. A whole lot of silence. Still, every now and then … ”
I proceeded to tell the following story.
The kids were out of town, so LeAnn and I took off to one of our favorite restaurants for some pizza and beverages. You know, one of those places the kids will never choose when we take them out to eat with us.
Ahh, date night out on the town. We could relax and unwind from what had been a stressful week filled with extremely bad medical news.
But things didn’t turn out that way. We couldn’t relax. We had important business to discuss. Big decisions loomed on the horizon, decisions regarding health and finances and preparing for the worst. How would LeAnn, a teacher, manage without my income? What would she do about the mortgage and upcoming college expenses? How would social security and life insurance factor in?
Yikes!
One thing they don’t tell you about terminal illness is how many huge decisions you must make every day. I’m talking enormously big and excruciatingly tough decisions, all the time. And quite often those decisions lead to disagreements. With terminal illness, two lives that once became one, begin to separate. Inevitable conflicts of interest begin to emerge.
As the pizza arrived, LeAnn and I found ourselves arguing about such issues. She was scared. I was scared. And each of us had our own point-of-view about what we should do about it. (By the way, during normal times, we hardly ever argue. But these were not normal times.)
The argument eventually progressed to the point that we stopped talking altogether. We were like two senior citizens sitting across from each other at dinner, never saying a word.
“What, you’re not going to talk to me now?” I asked with an edge in my voice.
“Sure, I’ll talk,” LeAnn said sarcastically. “What do you want to talk about? Just let me know the subject and we’ll talk.”
“I know,” I replied. “Let’s talk about getting the heck out of here!” (Except I didn’t say heck.)
Minutes later we were in the car heading home. Neither of us spoke a word during the drive. And upon arriving, we went our separate ways. LeAnn took off to Target to get a gift for a friend. I went to bed to read.
While she was gone, my mood began to soften. I must be bigger than this, I thought. My wife is in a terrible predicament and I’m not helping her by getting angry.
Later, when she got home, I apologized. But it was too little, too late.
“It’s okay, Jim.” she said. “I’m not even sure whose fault it was. It could have been me. But I do know we had a night together and threw it away. And we’re never going to get it back.”
She was right, of course. No apology would give us back that night. Regret set in, big time, followed by frustration and sadness.
I felt alone. Very, very alone.
Just then the phone rang.
It was the mother of one of my wife’s students. She’d never called LeAnn at home before, but felt compelled to call that evening. For you see, she’d heard I was sick and that we had just returned from Houston with bad news.
She proceeded to tell LeAnn how much her kids loved her. “You’re their favorite,” she said. In fact one of her kids had said that LeAnn is “always happy, always in a good mood,” even when things were going so wrong in her life at home.
“You’ve made a big difference,” the mother said.
I watched as tears began rolling down my wife’s cheeks.
“It’s been a tough week, and a really bad day,” LeAnn said. “I really appreciate the fact that you called.” They spoke for a while longer. And as they did, LeAnn’s mood changed. She laughed on the phone. She was at ease.
Afterward, when the phone call was over, LeAnn and I looked at each other and smiled. There were no words to say, but we took each other’s hand and held on tight. Then we turned out the lights on another crazy day.
Now I’m usually pretty darn skeptical when seemingly random events like this are interpreted as having a “higher” purpose. And I’m not saying this phone call necessarily did either. For all I know, it was just a matter of human kindness breaking through. Good things happen as a result of good deeds.
But, man, the timing of that phone call.
Something’s Fishy
Here’s a poem I wrote during chemo, the one that goes with the new video by John Clanton:
My Cancer Journey Acted Out in a Fish Tank
The cancer center’s aquarium
is so peaceful and serene
until you study if for awhile
and discover that one fish
is terrorizing all the others.
They’re collectively aware of him
at all times. (I assume the bad guy’s
male due to the aggression,
who else starts wars, but the culprit
could be female for all I know.)
Anyway, I watch in fascination
as this hellish underwater existence
plays out. The clown fish
and little orange and black dudes
hide easily in nooks and crannies,
staying beyond the bully’s bite.
But the unfortunate blue one’s
too big and has no choice
but to swim out in the open
where the striped terrorist lurks.
His life’s a constant escape,
putting distance between himself
and his nemesis, who’d nip
his tail at a moment’s notice.
Soooo déjà vu.
The Massage
I had a massage yesterday.
I’d received a gift card for the massage many months ago, but I still hadn’t used it. You see, I’ve had this disgusting rash for months due to a drug I take with chemo. (You can see evidence of the rash on the newsok.com video, when I’m talking about making memories.) Since I can hardly stand to look at the rash, I just couldn’t bring myself to make some poor massage therapist put her hands on it, even if that is kind of her job.
Anyway, I’ve stopped taking that particular drug, thank God, and the rash is nearly gone. So it was time to cash in. Plus, I’ve been having back issues.
Still, I must admit I’m pretty uncomfortable when it comes to massages. I’ve got so many issues with my pathetic body that I’m unsure of the protocol involved.
First, my right arm is, uh, missing. That’s a little awkward. So we have to begin by covering how much pain I have in the “scarred area,” or whatever we’re calling it that day. Plus, with no right shoulder, forearm or hand to rub, the timing’s all off. The masseuse has to call an audible, adjusting her schedule along the way.
Second, I have a port. That’s a little awkward. A port is an implanted device the doctors use to access my arteries during chemo. (In other words, that’s where they plug me in to pump poison into my system.) For a massage therapist, however, a port is known as an “area to avoid.” So I had to alert her to that fact.
Third, I have a titanium pump about the size of a can of tuna implanted in my stomach. That’s a little awkward, if not shocking. If the massage therapist had touched this area without knowing it’s there, I’m fairly sure she would’ve screamed. So more disclosures.
Fourth, my body is cold to the touch, only minimally warmer than your average cadaver. That’s a little awkward. The massage therapist would surely consider dialing 911 if she didn’t know about my temperature issues. So I told her about it.
Fifth, I’m missing a large muscle in my back, due to a reconstructive surgery I had in those early cancer days. That’s a little awkward. Massage therapists like to trace up and down most of your major back muscles in order to work things out. I thought about explaining, but all these pre-massage disclosures were cutting into my actual massage time. So I stayed quiet, hoping she’d figure it out by the scars.
Same for the large splotches of missing hair on my legs, a result of chemo. These make me look like I’ve been shaving my legs, but have somehow missed entire areas here and there. Awkward! But there was no time to get into it. Plus, who really cares, when it comes right down to it, if the masseuse secretly pegs me as a possible cross-dresser?
I also failed to mention the area on my foot where skin is peeling off due to chemo. That may have been a mistake, however, as I’m pretty sure the poor woman was dadgum startled by it. But hers is a profession where some sort of surprise would seem rather commonplace.
Afterward, I felt kind of guilty, putting her through the drama that is me. Hopefully, the tip I left will result in some measure of forgiveness.
I’m Just a Bill
When you’re dealing with a serious illness, it’s the little things that can send you over the edge.
Oh, you might be able to handle the mounting stress relating to children, medical appointments, tough conversations, disrupted schedules, the strain on relationships, even the overall sadness of it all. But then you have to deal with something like a medical bill and you lose it. Words you never dreamed of saying burst forth from your mouth like aftershocks from an earthquake.
Fortunately, I have good health insurance. And with chemotherapy running at about a $70,000 per month clip (I kid you not), my family would be sunk without it. Bills come in at a staggering pace, and somehow, some way, most of them get paid.
But every now and then, one slips through. And that one bill can cause more stress than you could ever imagine.
For example, I have this bill right now that’s driving me nuts. I’ve spent hours upon hours attempting to resolve it. I’ve written letters. I’ve made at least fifteen phone calls. And despite all that work, I’m no closer to resolving it.
The circumstances behind the bill are maddening in and of themselves. I was having surgery at M.D. Anderson Cancer Center in Houston. My insurance, through the State of Oklahoma, had approved this surgery and was treating it as an in-network expense. (This is one of the few benefits of having freaky rare cancers, like I have.) That’s good, because out-of-network expenses are akin to having no insurance at all.
Anyway, on the night before surgery, my son Ford came down with a horrible sore throat. Having no local doctor nearby, we got him some over-the-counter meds and hoped for the best. But as the night wore on, things were looking grim. Ford couldn’t even swallow.
The next morning my wife and I got up at 5 a.m. and headed over to the hospital. LeAnn waited until I was admitted, then rushed back to the nearby hotel room to check on Ford. He was in awful shape, but ibuprofen and water would have to do. LeAnn then rushed back to the hospital and waited for me to get out of surgery. The moment she received word that I was still alive, she sent our daughter Maddye over to wait on me to get out of recovery, then hurried back to get Ford to a doctor.
LeAnn had no idea where to go. But M.D. Anderson is in Houston’s medical district, and there’s a hospital on just about every friggin’ corner. So she chose one. I don’t want to name it here, but let’s just say it hypothetically rhymes with Saint Duke’s.
It was a quick in-and-out visit to the emergency room. Ten minutes with a doctor and a strep test, which proved negative. That’s it.
A month or so later, we received the bill. Actually, it was two bills, one from the hospital and one from the doctor. The total? One thousand bucks. (As I’ve said many times before, “Yikes!”)
Then, a couple of weeks later, we received an explanation of benefits from my insurance company’s “third party administrator”. They’d only paid $32, because the charges were out of network.
I called my insurance company to complain. They should treat these bills as “in network,” because we were in Houston getting surgery that was being treated as “in network.”
“You’ll need to file an appeal,” the tired voice on the phone explained. “And attach all the bills you have.”
So I did. But I first called the hospital and doctor to let them know that there would be a delay in payment due to a dispute on the bill. They noted this for the file. Then about a week later, they began calling my wife’s cell phone at work, urging her to pay her debt. This led my overworked, overburdened wife to urge me to “take care of this!”
It gets worse of course. The letter in response to my appeal came back, indicating that the bills had already been paid. That is, by paying less than fifty bucks on a thousand dollar bill, my insurance company had satisfied their contractual responsibilities.
“They didn’t even read my appeal letter,” I told LeAnn. “Or else they didn’t understand it.”
I wrote another appeal letter, explaining why this was wrong and again attaching all documentation I had. Then I called the third party administrator to voice my concerns.
A tired voice on the other line explained that the rejection was standard procedure. “We’re going to need to see the medical records,” she said.
“What medical records?” I asked. “It was a fifteen minute visit to the emergency room for a strep test! Says so right here on the bills. What other medical records could there be?”
“I don’t know,” she said. “But we’re going to need ‘em.”
“But why?” I, the lawyer, asked. “You’ve already made payments on these bills, thereby admitting they’re legitimate. Why would you need anything more? It’s nothing but added bureaucracy!”
“Sir, I understand your point, but it’s standard procedure. If it’s out of network, we’re gonna need the medical records.”
“Well, have you asked for them?” I asked. “I mean, you have the phone numbers right there on the bills.”
“That’s the patient’s responsibility.”
No need to tell you any more of this conversation. It was like talking to a brick wall. A very tired brick wall.
I then called the hospital to explain why they still hadn’t been paid, to urge them to stop calling my wife at her middle school, and to order the medical records.
“I can’t get you the medical records,” the lady at the business office explained. “That’s another department.”
“You’re in the business office and you can’t get medical records from your own hospital?” I asked with skepticism in my voice.
“Uh-huh. And why are you calling anyway? If your insurance company needs documentation, they should call and ask for it.”
“That’s what I told them, but they wouldn’t do it!”
“They just don’t want to pay for the records. I mean, someone’s gotta pay before we just up and send a bunch of records.”
“Well, there shouldn’t be anything but a page or two,” I assured her. “It was less than fifteen minutes. A strep test. That’s it.”
“We still need to get paid.”
“Listen, can’t you just call my insurance company and work this out?” I pleaded. “Why do I have to be the middleman? Like I’ve got nothing better to do. I’m dying out here. Literally.”
“Sir, we don’t call the insurance companies. They call us.”
She finally gave me the number to medical records. I waited a day or two before calling, in order to compose myself.
“Sure, we can send those records to your insurance company,” the cheerful voice on the phone said. “But we’re going to need your written authorization first.”
“Okay… And how’s the best way to get that done? Can you email me a form that I can print out and fax back to you?”
“I sure can,” said Miss Sunshine.
She then obtained my email information, and we hung up. That was four days ago. I still haven’t received an email.
“You still haven’t taken care of the Saint Duke’s bill?” LeAnn asked.
&$%@#$!@?!!!
